Individual
MS. LISA BEVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC,LMHC,NCC,CADCI
Contact information
Practice address
3175 NE ALOCLEK DR, HILLSBORO, OR 97124-7135
(503) 403-4072
Mailing address
3175 NE ALOCLEK DR, HILLSBORO, OR 97124-7135
(503) 403-4072
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
15-10-04
OR
101YP2500X
Professional Counselor
Primary
C3905
OR
101YP2500X
Professional Counselor
LH60737045
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093075996
—
AR
Enumeration date
05/24/2012
Last updated
12/17/2021
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